Tian S., Song X., Wang Y., Wang X., Mou Y., Chen Q., Zhao H., Ma K., Wu Z., Yu H., Han X., Wang H., Wang S., Ji X., Zhang Y. Chinese herbal medicine Baoyuan Jiedu decoction inhibits the accumulation of myeloid derived suppressor cells in pre-metastatic niche of lung via TGF-/CCL9 pathway. Available at: http://www.plantsoftheworldonline.org (Accessed December 18, 2021). Here, we performed a meta-analysis of 217 Chinese experimental studies to evaluate the safety of LHQW. MANILA, Philippines The Makati Medical Center's therapeutics and medication safety committee (TMSC) has said that the Chinese drug, Lianhua Qingwen (LQ), should not be taken without a doctor's prescription to ease new coronavirus disease (COVID-19) symptoms, warning that it may do more harm than good. Inclusion in an NLM database does not imply endorsement of, or agreement with, Bras (1992). Nervous system damage was described as an adverse event in 34 studies. 6 (01), 6364. doi:10.3969/j.issn.1672-2809.2020.13.020, Liu, C. Y., Li, X. Q., and Cai, S. Q. Lianhua Qingwen(Forsythiae fructus 225 mg, Lonicerae japonicae flos 225 mg, Ephedrae herba (processed w/ honey) 85 mg, Armeniacae semen amarum (stir-baked) . LHQW: Lianhua Qingwen. Li L.C., Kan L.D. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. This study was supported by the COVID-19 Pneumonia of Traditional Chinese Medicine Emergency Project, State Administration of Traditional Chinese Medicine of the Peoples Republic of China (2020ZYLCYJ02-1). However, in evaluation of security index, Eggers test and funnel plot analyses disclosed the existence of publication bias with regard to hepatobiliary system damage, psychiatric disorders, gastrointestinal system damage and body as a whole-general disorders. Effect of Maxing Shigan Tang on H1N1 influenza A virus-associated acute lung injury in mice. Drug Related Hospital Admissions: the Role of Definitions and Intensity of Data Collection, and the Possibility of Prevention. Current evidence shows that Lianhua Qingwen capsule is more effective and safer than Oseltamivir, Ribavirin and Ankahuangmin capsules. Case reports, unrelated studies, those with duplicate data, reviews, commentaries and animal-based studies were excluded from the current meta-analysis. Mo H.Y., Yang Z.F., Zheng J.P., Mo Z.Y., Li Y.M., Xiao Z.L. Effect of Lianhua Qingwen capsule on immunity of mice infected with flu virus. Pulmonary Rale.Eighteen studies reported an effect on the duration of pulmonary rale. Due to the inclusion of Ephedra people with high blood pressure, anxiety, history of seizures, irregular heart beats, or other heart heart conditions, should avoid taking Linhua Quingwen. (1990). Objectives: Lianhua Qingwen capsule/granule (LHQW) is an innovative patented traditional Chinese medicine with potential curative effects on respiratory diseases. Clinical Practice Guideline on Treating Influenza in Adult Patients with Chinese Patent Medicines. Fig. 7 (3), 177188. doi:10.13412/j.cnki.zyyl.2010.06.026. the Need for Accurate Scientific Nomenclature for Plants. Traditional Chinese medicine formulation used for the treatment of influenza, Uses and controversies of Lianhua Qingwen in relation to COVID-19, by region, "How traditional Chinese medicine TCM is used to treat Covid-19", "The mechanisms and clinical application of Traditional Chinese Medicine Lianhua-Qingwen capsule", "Clinical applications and pharmacological research progress of Lianhua Qingwen capsules/granules", "Traditional Chinese cures battle for acceptance in COVID-19 fight", "Chinese traditional medicine for Covid-19 becomes money tree", "Efficacy of Lianhua Qingwen Compared with Conventional Drugs in the Treatment of Common Pneumonia and COVID-19 Pneumonia: A Meta-Analysis", "Doctors warn against claims that Beijing-touted health supplement distributed in Canada treats COVID-19", "The Adverse Reactions of Lianhua Qingwen Capsule/Granule Compared With Conventional Drug in Clinical Application: A Meta-Analysis", "Beijing pushes traditional Chinese medicine as coronavirus treatment", "China Covid-19 tsar pushed treatments without revealing business ties", "Efficacy and Safety of Lianhuaqingwen Capsules, a repurposed Chinese Herb, in Patients with Coronavirus disease 2019: A multicenter, prospective, randomized controlled trial", "Prominent Chinese scientist failed to disclose company ties in COVID-19 clinical trial paper", "DOH and FDA Clarify Claims on the Approval of Potential COVID-19 Treatments and Calls for Resignation of the SoH", "Lianhua Qingwen, the FDA-approved traditional Chinese med, only treats symptoms, not COVID", "HSA Advisory on Lianhua Qingwen Products for Prevention or Treatment of COVID-19", "Fraudulent Coronavirus Disease 2019 (COVID-19) Products", "Chinese medicine Lianhua Qingwen makes its way into community for COVID-19 treatment despite Australian ban", https://en.wikipedia.org/w/index.php?title=Lianhua_Qingwen&oldid=1143380058, Short description is different from Wikidata, Articles needing expert attention from January 2023, Medicine articles needing expert attention, Articles containing simplified Chinese-language text, Articles containing traditional Chinese-language text, Articles with unsourced statements from August 2022, Creative Commons Attribution-ShareAlike License 3.0, Treatment against various respiratory diseases including, This page was last edited on 7 March 2023, at 11:01. Homogeneity of baseline data was reported in most studies. A Trial of Lopinavir-Ritonavir in Covid-19. Control. Accessibility Nevertheless, pressing researches should be conducted to illuminate the unconfirmed effects, regulatory mechanisms and adverse reactions of LHQW in treating COVID-19. A Working List of All Plant Species. doi:10.1590/1806-9282.66.6.771, Khan, Z., Karata, Y., and Rahman, H. (2020). 3.2.2. Drugs and Clinic. Anti-viral effects of Lianhua Qingwen capsule against influenza A virus. Front. Liu-Cheng Li was responsible for drafting the manuscript. Theoretical Study of the Anti-ncp Molecular Mechanism of Traditional Chinese Medicine Lianhua-Qingwen Formula (Lqf). Finally, 217 experimental studies on the Chinese population were included for study featuring 1759 cases of adverse reactions following clinical treatment (publication years ranging from 2005 to 2021). (Hongjingtian), Mentha haplocalyx Briq. [Saururaceae; Houttuyniae Botanical drug], a composition of LHQW (Huang et al., 2021), that contains allergenic ingredients, such as chlorogenic acid, as well as the unstable nature of houttuyfonate, which can cause adverse reactions (Cao, 2016). Use Overdosage Contraindications Special Precautions Adverse Reactions Storage MIMS Class ATC . Prof. Zhenhua Jia formulates the prescription of Lianhua Qingwen based on the theory of collateral disease, and participates in the research projects of Lianhua Qingwen against H 1 N 1 and COVID-19. Systematic Review Registration: https://clinicaltrials.gov/, CRD-42020224180. 343, d5928. Lianhua-qingwen Displays Antiviral and Anti-inflammatory Activity and Synergistic Effects with Oseltamivir against Influenza B Virus Infection in the Mouse Model. [12], In April 2022, the Financial Times reported that the leading COVID-19 health official in the PRC, the famous epidemiologist and pulmonologist Zhong Nanshan - who has also been the most prominent scientific promoter of Lianhua Qingwen - had undisclosed prior investments in large stakeholdings in corporations producing Lianhua Qingwen and other treatments under question. Sci.). Liu, X. Y. Keywords: Lianhua Qingwen, adverse reaction, COVID-19, influenza, traditional Chinese medicine, meta-analysis, Citation: Hu C, He B, Gong F, Liang M, Zhao D and Zhang G (2022) The Adverse Reactions of Lianhua Qingwen Capsule/Granule Compared With Conventional Drug in Clinical Application: A Meta-Analysis. Chakraborty C., Sharma A.R., Sharma G., Bhattacharya M., Lee S.S. SARS-CoV-2 causing pneumonia-associated respiratory disorder (COVID-19): diagnostic and proposed therapeutic options. (2020) identified 38 randomized controlled trials (RCTs) comparing LHQW with antivirals or other Chinese medicines for treating influenza and reported a lower risk of adverse reactions in the LHQW group compared to oseltamivir (RR = 0.29, 95%CI = 0.110.80), and ribavirin groups (RR = 0.29, 95%CI = 0.110.80). Second, one purposes of this study was to retrieve information on adverse reactions from different countries, due to language barriers, only English and Chinese articles were retrieved, and adverse reactions in the Chinese population were specifically analyzed, the effects on populations from other countries therefore require further investigation. [8] A January 2022 meta-analysis from China reports that it may cause GI discomfort, rashes and itches, dry mouth, and dizziness, but emphasizes that the effects are more common with "conventional treatment". Lianhua Qingwen (LHQW) is a commonly used Chinese medical preparation to treat viral influenza, including in the fight against SARS in 20022003 in China. Efficacy and Safety of Lianhua Qingwen Granule Combined with Oseltamivir in the Treatment of Influenza Virus Infection in Children. doi:10.1007/s12325-020-01351-9, Kupferschmidt, K., and Cohen, J. Business China. This review provides comprehensive evidence of LHQW as a complementary strategy for treating COVID-19. A multi-center, randomized, double-blind, and placebo-controlled phase II clinical study, sponsored by Yiling Pharmaceutical Inc., was conducted to investigate the safety and efficacy of two doses of LHQW capsule compared to placebo in subjects with acute uncomplicated influenza in the U.S.A (https://www.clinicaltrials.gov/ct2/show/study/{"type":"clinical-trial","attrs":{"text":"NCT02867358","term_id":"NCT02867358"}}NCT02867358). Zhu S.Y., Li X.Y., Wei Y.L., Yang P.Y., Qin E.D. The current meta-analysis was conducted to systematically evaluate the security of LHQW compared with conventional drug in clinical application. LYY19H280006, No. An outbreak of Coronavirus Disease 2019 (COVID-19) which was infected by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is still spreading and has led to unprecedented health emergency over the world. 17 (13), 6264. In the evaluation of security indexes, LHQW group has a reduced incidence of respiratory system damage, skin and its appendages injury, nervous system damage and gastrointestinal system damage, along with other adverse reactions. Lianhua Qingwen capsule/granule (LHQW) is obtained by combining Ma Xing Shigan Decoction with Yinqiao Powder and widely used in the clinical treatment of respiratory disorders (Liu et al., 2010). In recent years, LHQW has been registered to obtain marketing authorization in Canada, Brazil, Singapore, Thailand, the Philippines, Kuwait and other countries under the designation Chinese patent medicine, medicine, physical natural health products, food supplement, modern botanical medicine or natural medicine (Yiling Pharmaceutical, 2020). The cochrane Collaboration's Tool for Assessing Risk of Bias in Randomised Trials. Ther. Yiling Pharmaceutical (2021). The complex components of LHQW stand for multiple targets and pleiotropic effects, but may also lead to more ADRs. Royal Botanic Gardens, Kew (2021). Percentage of risk of bias for all qualified studies. Adverse Drug Reactions to Antibiotics Observed in Two Pulmonology Divisions of Catanzaro, Italy: a Six-Year Retrospective Study. CFDA has recently approved adding a new indication for LHQW in mild and common COVID-19 patients, but whether it would bring benefits for the severe cases is unclear. Wu et al. Both Lian-Hua-Qing-Wen Capsule (LHQWC) and Jin-Hua-Qing . Recent data indicated that orally administered LHQW capsules (100400mg/kg/day) could alleviate IBV-induced pathological change and decrease the abnormal increased inflammatory cells in lung tissues, but did not reduce the lung viral load and mortality in mice [26]. doi:10.1097/MD.0000000000026059, Gallelli, L., Ferreri, G., Colosimo, M., Pirritano, D., Guadagnino, L., Pelaia, G., et al. Efficacy and Safety of Lianhuaqingwen for Mild or Moderate Coronavirus Disease 2019. Pharmacol. Compared with the conventional drug group, the incidence of disease recurrence was lower in the LHQW group, implied that LHQW might could regulate and enhance the immune function of the body. Wang C., Horby P.W., Hayden F.G., Gao G.F. A novel coronavirus outbreak of global health concern. The majority of studies lacked sufficient description of allocation concealment and therefore, the project was predominantly evaluated as unclear risk of bias. Although the blinding method was not reported, since some symptom indicators needed measurement with instruments, assessment of symptom indicators was unlikely to be affected by the lack of blinding. Chin. The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future. (2021). Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. Twenty-three studies on other diseases were included, with 12 reporting adverse reactions. doi:10.11954/ytctyy.201608076, Chan, K. W., Wong, V. T., and Tang, S. C. W. (2020). Clinically, Lianhua Qingwen Capsule can be used in the treatment of cold, flu-induced bronchitis, pneumonia, COPD, interstitial pneumonia and other lung inflammation. Please be informed that only the Lianhua . The Trim and Fill method was further applied to assess the impact of publication bias. Traditional Chinese medicine has accumulated substantial clinical experience over thousands of years. Salvi R., Patankar P. Emerging pharmacotherapies for COVID-19. In our meta-analysis, information on adverse reactions was clearly reported in 12 of the 17 studies while the remaining five studies provided no specific evidence of adverse reaction specifically, and the incidence of adverse reactions was lower in LHQW group than that in the conventional drug group. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. [Cruciferae; Isatudus Radix] (255g), Dryopteris crassirhizoma Nakai [Polypodiaceae; Dryopteris Crassirhizomatis Rhizoma] (255g), Houttuynia cordata Thunb. The results remained statistically robust after different number supplement of potential studies (for hepatobiliary system damage: RR = 0.90, 95% CI = 0.60 to 1.34; for psychiatric disorders: RR = 1.00, 95% CI = 0.20 to 4.91; for gastrointestinal system damage: RR = 0.86, 95% CI = 0.76 to 0.98; for body as a whole-general disorders: RR = 0.73, 95% CI = 0.212.56). Besides, in view of the definite effects of LHQW in preventing severe viral infections such as SARS and COVID-19 [17,44,45,49,52,53], LHQW may represent a considerable and effective strategy against unknown viral epidemics. Received 2020 Jul 3; Revised 2020 Aug 9; Accepted 2020 Aug 16. (2016). The current meta-analysis was performed to evaluate the safety profile of LHQW in relation to conventional drugs (PROSPERO CRD-42020224180). For pooled studies, there was a significantly reduced risk of adverse reactions with LHQW group compared to the conventional drug group (RR = 0.63, 95% CI = 0.580.69, p < 0.001). There was no statistically significant difference in the incidence of adverse reactions during treatment of common pneumonia between the LHQW group and the conventional drug group (RR = 0.99, 95% CI = 0.791.24, p = 0.927). Subgroup analysis was performed based on adverse reactions and sensitivity analysis implemented to investigate the influence of each study on the overall evaluation by excluding studies in turn. World Health Organization Adverse Drug Reaction Terminology (2009). Lianhua Qingwen (LHQW) is a classical Chinese medical preparation, while one of its prescription compositions Maxingshigan Decoction has a history of more than thousand years to treat plague, and exhibits antiviral and lung protection actions [15,16]. Inhibitorv Effect of Lianhua Oingwen Water Extract on Methicillin-Resistant staphylococcus Aureus Biofilm In Vitro. We aim to assess the efficacy and safety of Lianhua Qingwen combined with Conventional antiviral Western Medicine in Clinical treatment of COVID-19 or asymptomatic infection. ACE2, angiotensin-converting enzyme 2; ADRs, adverse drug reactions; AECOPD, acute exacerbation of chronic obstructive pulmonary disease; AGE, advanced glycation end products; ALI, acute lung injury; COPD, chronic obstructive pulmonary disease; COVID-19, Coronavirus Disease 19; EC50, median effective concentrations; HPLC, high performance liquid chromatography; IBV, influenza B virus; IFN, interferon; IL, interleukin; LHQW, Lianhua Qingwen; LPS, lipopolysaccharide; IP, interferon-inducible protein; MCP, monocyte chemoattractant protein; MIP, macrophage inflammatory protein; NF-B, nuclear factor-kappa B; RAGE, receptor of advanced glycation end products; SARS, Severe Acute Respiratory Syndrome; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2; TCM, traditional Chinese medicine; UPLC-DAD-QTOF-MS, ultraperformance liquid chromatography coupled with diode-array detector and quadrupole time-of-flight mass spectrometry, Coronavirus, SARS-CoV-2, Lianhua Qingwen, Antiviral activity, Complementary strategy, {"type":"clinical-trial","attrs":{"text":"NCT02867358","term_id":"NCT02867358"}}. 11 (31), 52605355. Clin. Pharmacol. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. Literature analysis of Chinese patent medicine treatment in the observation period of Clinical Management of Corona Virus Disease 2019 (trial 6th edition). Wang S.H., Liu J.F., Zhang Y.L., Dong Z. The post-marketing monitoring data incorporated information on the following gastrointestinal adverse reactions: nausea, diarrhea, vomiting, abdominal pain, abdominal distension, dry mouth; as well as skin rash, itching, dizziness (Yiling Pharmaceutical, 2021). (2010). BMJ. Hence, the researches on specific active components of LHQW are still important and the reduction of irrelevant ingredients may be related to less adverse reactions. Therefore, it is essential to perform a systematic review and meta-analysis to assess the effect of Lianhua Qingwen combined with conventional antiviral Western Medicine in clinical treatment of COVID-19 or asymptomatic infection. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., Zhao X., Huang B., Shi W., Lu R., Niu P., Zhan F., Ma X., Wang D. A novel coronavirus from patients with pneumonia in China, 2019. In addition to western medicine, the potential adverse drug reactions (ADRs) can not be ignored. These above ingredients are decocted, distilled, filtered, refrigerated, mixed well with powdered sugar, dextrin or starch, dried and finally made into LHQW (Chinese Pharmacopoeia, 2020). Lianhua Qingwen(Forsythia suspensa (Thunb.) Drafting of the manuscript was done by CH and BH. Seven of the studies showed that adverse reactions improved or healed spontaneously without any treatment, five reported that adverse reactions healed spontaneously after discontinuation of medication, eight showed that adverse reactions improved or healed with medication after meals and ten showed that adverse reactions improved or recovered after symptomatic treatment, while in the remaining eight studies, adverse reactions were not disposed or treated.
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